Paraneoplastic syndromes in patients with melanoma.

Paraneoplastic syndromes are a group of rare clinical conditions characterized by a diverse array of systemic manifestations that arise in association with malignant tumours, often due to the production of bioactive substances by the tumour or an autoimmune response to the tumour. Melanoma, a malignant skin neoplasm originating from melanocytes, has been associated with various paraneoplastic syndromes. This paper provides an overview of the key paraneoplastic syndromes observed in patients with melanoma. Paraneoplastic syndromes in melanoma can manifest with neurological, dermatological, endocrine, haematological, and rheumatological symptoms, among others. Melanoma-associated retinopathy was the most reported paraneoplastic syndrome; this entity is characterized by a spectrum of retinal abnormalities. Paraneoplastic neurological syndromes, such as paraneoplastic encephalitis and paraneoplastic cerebellar degeneration, are among the most frequently reported. The pathophysiology of paraneoplastic syndromes often involves the production of autoantibodies against neuronal or tumour antigens, immune-mediated reactions, or the release of cytokines and growth factors from the tumour. Management strategies for paraneoplastic syndromes associated with melanoma primarily focus on treating the underlying malignancy, which may lead to resolution or improvement of the paraneoplastic manifestations. Immune-modulating therapies, including corticosteroids, intravenous immunoglobulins, and plasmapheresis, may be considered in selected cases to ameliorate symptoms and suppress the autoimmune response. In conclusion, paraneoplastic syndromes in patients with melanoma are a complex and diverse group of clinical entities with a broad range of presentations. Further research is needed to enhance our understanding of the mechanisms and therapeutic options for paraneoplastic syndromes associated with melanoma.

Aryl hydrocarbon receptor role in chronic inflammatory skin diseases: a narrative review.

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor that has gained increasing attention in the field of dermatology due to its multifaceted role in skin health and disease. This review provides a comprehensive overview of the current state of knowledge regarding the AHR and its implications in dermatological conditions. The AHR is well known for its involvement in xenobiotic metabolism, particularly in response to polycyclic aromatic hydrocarbons and dioxins. However, recent research has unveiled its pivotal role in the skin immune response, barrier function, and homeostasis. The AHR signalling pathway is intricately linked to various dermatological disorders, including psoriasis, atopic dermatitis, acne and hidradenitis suppurativa. In this review, we delve into the molecular mechanisms through which AHR activation influences skin physiology and highlight how dysregulation can lead to pathological conditions. Moreover, we discuss the emerging therapeutic potential of AHR modulators in the treatment of skin diseases. In conclusion, the AHR is a pivotal player in dermatology, with a multifaceted role in skin physiology and pathology. Understanding the intricacies of AHR signalling in the skin offers promising avenues for the development of novel therapies and preventive strategies for various dermatological conditions. Further research is warranted to elucidate the full scope of AHR's contributions to dermatology and its potential as a therapeutic target.

Assessment of the anxiety and depression among patients with idiopathic pruritus ani.

INTRODUCTION: Pruritus ani is an unpleasant sensation that leads to scratching of the skin around the anus. It is a common symptom due to many systemic, dermatological, and proctological conditions. In the absence of evident organic origin of a disease, pruritus may be related to mental disorders as well as personality disorders. AIM: To assess the influence of pruritus on anxiety and depression in these patients. MATERIAL AND METHODS: The study involved 60 patients complaining of persistent pruritus ani. The study included people in which pruritus for organic reasons was ruled out. Tests were carried out to assess the level of depression and anxiety disorders. In addition, patients were asked to fill in the Questionnaire for the Descriptive Assessment of Pruritus and the 4-Item Itch Questionnaire by prof. Jacek Szepietowski. RESULTS: The cause of pruritus ani in the study groups has been shown to have a significant influence on the level of depressive symptoms. There was no such relationship for anxiety disorders. In the study group, there was no correlation of depressive-anxiety symptoms with the level of pruritus intensity and the frequency of pruritus. CONCLUSIONS: The presented data reveal the negative effect of pruritus ani on the psychological functioning of patients. Pruritus ani is characterized by moderate intensity of pruritus, but has a significant influence on the aggravation of depressive symptoms. It is important to look for the causes of this symptom, which can help to eliminate its intensity, improve the patients' mood, and thus improve their quality of life.

Comparison of ultrasound therapy and radial shock wave therapy in the treatment of venous leg ulcers - clinical, pilot study.

INTRODUCTION: Venous insufficiency and venous leg ulcers each year affect more and more people, especially in developed countries. The challenge of our time is to find an effective method of treating venous leg ulcers, which will further shorten treatment time and reduce the cost of treatment. AIM: To compare the effects of treating venous leg ulcers using ultrasound therapy, radial shock wave therapy and standard care. MATERIAL AND METHODS: Group A consisted of 17 patients. Patients were treated with ultrasound therapy US power density 0.5 W/cm2, pulsed wave with a duty cycle of 1/5, and 1 MHz frequency. Group B consisted of 17 patients. Patients were treated with the radial shock wave R-ESWT using surface energy density 0.17 mJ/mm2, 100 impulses/cm2, frequency of 5 Hz and a pressure of 0.2 MPa. Group C (control group) consisted of 17 patients. Patients in this group received standard care: gauze dressing saturated in 0.9% sodium chloride and elastic bandages changed daily for 4 weeks. RESULTS: Ultrasound therapy with 1 MHz and energy power density 0.5 W/cm2 for 4 weeks resulted in an average reduction of 68% of the area of ulceration. We used for venous leg ulcers 4-week treatment with radial shock wave therapy resulting in a 38% mean percentage reduction of the ulceration area. Standard care reduces the area of ulceration by only 16%. CONCLUSIONS: The use of ultrasound therapy for the treatment of venous leg ulcers is more effective than the use of radial shock wave therapy or standard care alone.

Randomized, controlled clinical pilot study of venous leg ulcers treated with using two types of shockwave therapy.

Background. Venous leg ulcers are difficult to heal wounds. The basis of their physiotherapeutic treatment is compression therapy. However, for many years, the search for additional or other methods to supplement the treatment of venous ulcers, which would shorten the duration of treatment, is underway. One of such methods is the shockwave therapy. Methods. The purpose of our study was to compare radial shockwave therapy (R-ESWT) with focused shockwave therapy (F-ESWT) in venous leg ulcers treatment. Patients were randomly assigned to tree groups. In the first group the radial shockwave therapy (0.17mJ/mm2, 100 impulses/cm2, 5 Hz), in the second group the focused shockwave therapy (0.173mJ/mm2, 100 impulses/cm2, 5 Hz) was used and in third group standard care was used. Patients in shockwave therapy groups were given 6 treatments at five-day intervals. Total area, circumference, Gilman index, maximum length and maximum width of ulcers were measured. The patients from the third group wet gauze dressing with saline and gently compressing elastic bandages were used (standard wound care SWC). Results. Analysis of the results shows that a complete cure of ulcers was achieved in 35% of patients who were treated with radial shockwave, 26% of patients with focused shockwave used. There is statistically significant difference between the standard care and radial shockwave therapy as well as between the standard care and focused shockwave therapy. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers (p> 0.05). Conclusion. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers. Treatment of venous leg ulcers with shockwaves is more effective than the standard wound care.

Shockwave therapy in selected soft tissue diseases: a literature review.

OBJECTIVE: The aim of our study is to present the current state of knowledge on the use of shockwave therapy (SWT) in the treatment of soft tissue wounds, by reviewing the available literature. METHOD: Medical databases were searched for articles using the keywords: 'shockwave AND wound healing', 'shockwave AND ulcers', 'shockwave AND burns', 'shockwave AND bedsores', 'shockwave AND diabetic foot ulcer', 'ESWT AND wound healing', 'shock wave AND diabetic gangrene'. RESULTS: A total of 14 scientific articles were included in the study which described the methodology of treatments and list the type of generator, physical parameters used during the procedure, number of treatments and the type of treated wounds. From these articles, 191 soft tissue wounds were analysed. CONCLUSION: Evidence from the articles analysed in this study suggests a beneficial effect of SWT to treat diabetic foot ulcers, venous leg ulcers, pressure ulcers and burns. SWT can be used in combination with standard treatment in soft tissue wounds.

Neurological abnormalities in localized scleroderma of the face and head: a case series study for evaluation of imaging findings and clinical course.

INTRODUCTION: Localized scleroderma (LoS) of the face and head is often associated with neurological manifestations and/or imaging abnormalities in the central nervous system (CNS). CASE SERIES: We present an analysis of 20 cases of LoS affecting the face and head. The CNS symptoms and/or abnormalities in high-resolution computed tomography (HRCT) and/or magnetic resonance imaging (MRI) were observed in 12 patients (60%). In addition to the mild and unspecific disorders (e.g. headaches), serious neurological complications probably in the course of vasculitis were revealed: epilepsy (in two patients), epilepsy and pyramidal sings (in one patient). Neurological disorders and LoS occurred at the same time (in three patients) or at the course of the disease (nine patients) and no later than 29 years since the onset of the disease. No link between neurological disorders and the LoS clinical morphology, immunological and other laboratory parameters has been established. CONCLUSIONS: CNS involvement is not correlated with the clinical course of the facial and head LoS and may occur years after the disease initial symptomatology. Imaging follow-up is not required if there is not any emerging neurological symptom. In some cases, however, both HRCT and MRI are useful for monitoring disease evolution and addressing therapeutic choices.

Extensive phlegmon and pyoderma gangrenosum: diagnostic difficulties.

Pyoderma gangrenosum (PG) is a relatively rare neutrophilic dermatosis, characterized by progressive skin necrosis. It typically has a chronic course, of unknown etiology. Pyoderma gangrenosum diagnosis can be difficult because both histopathological examination and results of additional laboratory tests are not specific and the clinical state is conclusive, as for other physicians it poses a number of diagnostic dilemmas. Therefore, this condition should be treated interdisciplinary. We present a case of a 40-year-old patient with a diagnosis of PG, which in the early stages of the disease was treated as an extensive phlegmon by physicians of other specialties and it presented a serious diagnostic as well as therapeutic problem.

Antiphospholipid antibodies in localized scleroderma: the potential role of screening tests for the detection of antiphospholipid syndrome.

INTRODUCTION: The presence of antiphospholipid antibodies (aPL) is associated with infections, drugs and autoimmune disorders. Those antibodies are also detected in approximately 5-20% of the healthy population. The presence of aPL can lead to the occurrence of thrombotic events or abortion, which define the antiphospholipid syndrome (APS). AIM: To evaluate the potential role of aPL in diagnosing APS in patients with localized scleroderma (LoS). MATERIAL AND METHODS: Serum samples from 45 patients with various forms of LoS were examined. They were screened with the commercially-available immunodot assay Anti-Phospholipid 10 Dot (GA Generic Assays GmbH, Dahlewitz, Germany). A number of clinical and laboratory parameters, especially APS symptoms, were assessed in patients with positive aPL: arterial and venous thrombotic events, obstetric complications, thrombocytopenia and neurological symptoms. RESULTS: THE FOLLOWING PROFILE OF APL IGG OR IGM WAS OBTAINED FROM PATIENTS WITH LOS: cardiolipin 15/45, phosphatidic acid 41/45, phosphatidyl-choline 0/45, -ethanolamine 6/45, -glycerole 1/45 (patient with Lyme disease), -inositol 7/45, -serine 14/45, annexin V 34/45, ß2GPI 21/45, prothrombin 30/45. Antiphospholipid antibodies profile screening in these individuals revealed two cases of suspected secondary laboratory APS. However, no such clinical and laboratory parameters were found in other LoS patients with positive aPL. Similarly, no association was found between the presence of aPL and either thrombotic events or other APS symptoms. CONCLUSIONS: Antiphospholipid antibodies are commonly found in patients with LoS but the exact role of these antibodies remains unclear. Clinical manifestations of APS are not frequently seen during LoS.

Determinants of environmental domain of quality of life in economically active population living in Silesian agglomeration, Poland.

OBJECTIVES: The aim of this paper is to identify the factors that determine the environmental domain of quality of life in economically active adults living in the industrial agglomeration in Poland. MATERIALS AND METHODS: During the cross-sectional epidemiological study conducted among the economically active population aged 45-60, we used a short version of the WHOQOL-BREF questionnaire. Respondents were recruited randomly from selected factories located in the Silesian Agglomeration. The statistical analysis used descriptive and analytical methods available in the Statistica 9.0 software. RESULTS: The results confirmed the statistically significant association between marital status, type of occupational activity, declared health status, and the environmental domain of quality of life in economically active inhabitants of the Silesian Agglomeration. The best qualities of life in the environmental domain were those of married people, white collars, and persons who declared their health status to be the best. CONCLUSIONS: The major determinants of environmental quality of life in economically active population living in the industrial agglomeration include non-occupational factors, such as marital status and current health status, while a significantly better quality of life was associated with being a white-collar worker and not living in the vicinity of the road with heavy traffic. The results may be useful for future planned activities intended to improve the health and the quality of working life.

[Quality of life of occupationally active people, aged 45-60, living in the Polish industrial region (Silesian agglomeration)]. / Jakoså zycia aktywnych zawodowo osób w wieku 45-60 lat, mieszkanców przemyslowego regionu Polski (aglomeracja górnoslaska).

BACKGROUND: Among the most important determinants of quality of life are socio-economic factors, including economic activity and support of family, environmental and indoor related factors, infrastructure and air quality. The aim of this publication is to identify the factors that determine the quality of life of economically active adults in the industrial agglomeration of Poland. MATERIALS AND METHODS: The epidemiological cross-sectional study was carried out among the economically active population of the Silesian Agglomeration. A short version of the WHOQOL-BREF questionnaire was used to ascertain the quality of life of individuals. Furthermore, the software Statistica 9.0 was used to provide analytical and descriptive statistical data. The influence of age, gender, education, type of activity and living environment were used to assess the quality of life in the somatic, psychological, social and environmental domains. RESULTS: It was found that among the important determinants of quality of life in economically active population, aged 45-60 years, living in the industrial agglomeration, were primarily marital status, education level and the current state of health. The data evidenced the worst quality of life among unmarried persons, persons with lower education levels and persons diagnosed with cardio- or respiratory diseases. CONCLUSIONS: There is a need to develop health conducive behavior among workers by providing training cycles with the involvement of staff supervising occupational health and safety. These types of actions can contribute to improving the quality of life of the working population.

[Selected problems concerning anaemia in systemic lupus erythematosus patients]. / Wybrane zagadnienia dotyczace wystepowania niedokrwistosci u chorych na toczen rumieniowaty ukladowy.

Haematological abnormalities are common in systemic lupus erythematosus (SLE) and may be manifested by anaemia of different pathogenesis. The objective of this article was to describe some data concerning autoimmune haemolytic anaemia, aplastic and megaloblastic ones accompanying SLE and also to present erythropoietin (EPO) function in the above mentioned diseases. In SLE many factors are produced which disturb the organism haematological balance both on the peripheral level and in the bone marrow. It is assumed that the autoantibodies produced in SLE are the main cause of anaemia. However it should be considered that quantitative changes in the number of erythrocytes observed in this disease are also caused by chronic inflammatory condition, which as the element of autoimmune disease impairs the endocrine function of the kidneys in EPO production. It influences bone marrow, iron metabolism and then haemopoiesis. Apart from humoral factors the role of mechanisms connected with immune cellular response is also considered.